Fig. 1. Flow diagram showing the selection process of articles included in the systematic review and meta-analysis.

Fig. 2. Forest plot comparing the technical efficacy of endoscopic ultrasound-giuded and endoscopic retrograde cholangiopancreatography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 3. Forest plot comparing the clinical efficacy of endoscopic ultrasound-giuded and endoscopic retrograde cholangiopancreatography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 4. Forest plot comparing total adverse events associated with endoscopic ultrasound-guided and endoscopic retrograde cholangiopancrea­tography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 5. Forest plot comparing rates of procedure-related pancreatitis between endoscopic ultrasound-guided and endoscopic retrograde chol­angiopancreatography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 6. Forest plot comparing the need for reintervention between endoscopic ultrasound-guided and endoscopic retrograde cholangiopan­creatography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 7. Forest plot comparing the incidence of acute cholangitis between endoscopic ultrasound-guided and endoscopic retrograde cholan­giopancreatography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 8. Forest plot comparing stent patency between endoscopic ultrasound-guided and endoscopic retrograde cholangiopancreatography biliary drainage in included studies. EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography; CI, confidence interval.

Fig. 9. Forest plot comparing the mean stent patency time between endoscopic ultrasound-guided and endoscopic retrograde cholangiopan­creatography biliary drainage in included studies. SMD, standardized mean difference; CI, confidence interval; SD, standard deviation; EUS, endoscopic ultrasound; ERCP, endoscopic retrograde cholangiopancreatography.

Graphical abstract